Loggerhead (Caretta caretta)

Case History

Emaciated, lethargic, and near death, this juvenile loggerhead stranded on the beach near Calhoun Street in Garden City. Local S.C.U.T.E. nesting beach volunteers assisted with the timely rescue and transport of this animal to our sea turtle hospital. Other than two old fish hooks embedded in the skin of the left front flipper and neck, this loggerhead did not have any physical injuries. However, it was clear to our staff at admission that this sea turtle had been ill and inappetant for weeks or months due to its extremely poor nutritional state and heavy load of epibionts on the shell and skin. This animal’s epibionts, which can provide clues as to where and how long sick sea turtles have been floating, included large bryozoans, various sessile barnacle species, and Ozobranchus leeches.

Treatment

Staff were ready and waiting to begin treating this turtle immediately upon its arrival just after 5:00 P.M. on Saturday evening, June 7th. Due to the decalcified state of this loggerhead’s skeletal system, s/he was kept on a soft bed of foam throughout the treatment process to prevent unintentional bone fractures. The heart rate was fairly strong (22 beats per minute, or bpm) at admission; however, blood work was very poor (PCV 3-4%, total solids 1.6, glucose undetectable). Our vet administered fluids, both subcutaneously and directly into the vascular system, to combat severe dehydration, edema, and anemia. Injectable vitamins and antibiotics were also given.
At 5:53 P.M., this loggerhead began to exhibit the classical signs of sea turtle death: s/he threw her head up and gasped a few times, moved her front flippers in an exaggerated fashion, and pulled the eyes deep into the skull. Despite the fact that we’ve never been able to recover a turtle from this state, our vet quickly administered epinephrine and placed a tube down the trachea so that we could “breathe” for her using an Ambu bag. Over the next 15 minutes, staff observed the return of the heart rate to a slow but regular-sounding 8 bpm, the return of the bite reflex, and autonomous muscle jerking transform into conscious flipper movement. We let her rest overnight on the ventilator after exhausting all of our treatment options. Prognosis is very poor.

Updates

12 June 2014: This loggerhead has remained under nearly constant supervision since admission by hospital staff during the day and our security team at night. We’ve continued treatments (fluids, antibiotics, etc.) and have offered food but, other than eating a single squid on the 10th, this turtle has no interest in eating. In an effort to initiate movement of the GI tract, we tube-fed this turtle a small amount of gruel today. Ten minutes later, she again exhibited signs of agonal death and was quickly rushed upstairs on a gurney to our medical lab for another dose of epinephrine, fluids, and intubation. The heart rate was restored, s/he began breathing on her own, and we are keeping her dry-docked on foam overnight. We’ve also given her the very fitting name of “Lazarus” since this is the first sea turtle we’ve successfully brought back from death – twice.
26 June 2014: Thanks to intensive and aggressive medical treatment, Lazarus remains alert and responsive in a shallow tank of water nearly three weeks after admission. Although s/he is still lethargic, her behavior is very normal for a loggerhead (there are no signs of neurological impairment). However, s/he continues to refuse all types of food (salmon, smelt, mackerel, trout, squid, etc.) even when it’s placed in her mouth. Subsequent tube feeding treatments have gone well, and we’ve also been successful providing both IV nutrition and in force-feeding her very small pieces of food. We’ve now seen two fecals and, although she is passing bile, it’s still a positive sign that her GI tract is moving. However, prognosis remains poor and we are continuing intensive treatments.
15 July 2014: The good news: Despite valiant daily attempts to encourage this weak turtle to eat on her own, Lazarus refused food – and immediately spit out food placed in her mouth – until July 1st, when she finally chewed and swallowed a small amount of mackerel. This was a huge step forward! We are continuing to feed very small amounts of fish twice a day, but must proceed slowly and carefully as her GI tract is basically shut down from long-term anorexia. Also, we are currently having to offer filets (no large bones or skin) as this loggerhead is an extremely finicky eater.
The bad news: We found a small segment of monofilament fishing line and two different pieces of sheet-like plastic in her fecal today. This is extremely concerning as there are likely additional foreign bodies in her system that are potential harmful. We are closely monitoring this very sick turtle for additional foreign materials and signs of impaction (none yet).
6 August 2014: Lazarus has progressed from being a finicky eater to now eagerly consuming nearly a pound and a half of whole fish each day! We are splitting her diet into breakfast and dinner to prevent overloading her sensitive GI tract. On a fabulous note, Lazarus passed her first formed and normal fecal on August 4th and has gained 11 pounds since admission!
15 September 2014: Staff pulled blood on this resilient turtle last Wednesday (9/10) to check on her internal health, and the results are astounding. Her hematocrit (red blood cell volume) is up to 21%, which is quite an improvement from the severely anemic state (PCV: 3-4%) she was in when she stranded. While her hematocrit is still lower than our minimum for release, her blood work results indicate that Lazarus is regaining her health.
8 April 2015: This loggerhead sea turtle will be remembered by staff and volunteers forever due to the astounding recovery we’ve been fortunate enough to witness over the past ten months. Lazarus has transformed from a skeletal turtle covered in epibionts and too weak to swim into a robust and aggressive loggerhead splashing around her hospital tank. Over the past few weeks, our vet and staff have carefully analyzed Lazarus’ recent blood work, swimming behavior, and ability to capture and consume live blue crabs. This turtle is strong in every category, and has been medically cleared for release.